MEDICARE: MENGCHUN CHIANG PHD, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS018021	PA
2	103TC0700X	Clinical Psychologist	10343	MA

General Provider Information

NPI Number	:	1821434994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MENGCHUN CHIANG PHD, LP

Provider Business Mailing Address
First Line	:	307 4TH AVE FL 11
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15222-2108
Country	:	US
Telephone Number	:	412-701-1366
Fax Number	:

Provider Business Practice Location Address
First Line	:	2015 DARTMORE ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15210
Country	:	US
Telephone Number	:	412-785-1086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2013
Last Update Date	:	07/06/2018

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